Provider Demographics
NPI:1154794311
Name:MORANT, NALO (LMSW)
Entity type:Individual
Prefix:
First Name:NALO
Middle Name:
Last Name:MORANT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2210
Mailing Address - Country:US
Mailing Address - Phone:313-274-3700
Mailing Address - Fax:313-274-4900
Practice Address - Street 1:2925 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207
Practice Address - Country:US
Practice Address - Phone:313-369-5300
Practice Address - Fax:313-369-5353
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI24700000X103K00000X
MI68010983601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1063764033Medicaid
MI1063764033Medicare NSC